SIR 2024
Embolization
Abby D. Liu, None (she/her/hers)
Student
The Johns Hopkins University School of Medicine
Financial relationships: Full list of relationships is listed on the CME information page.
Thalia Liu, None
Student
The Johns Hopkins University School of Medicine
Disclosure information not submitted.
Adham Khalil, MD
PGY-1 General Surgery Resident at MedStar Georgetown University;
Incoming IR/DR Resident at George Washington University
Johns Hopkins University
Financial relationships: Full list of relationships is listed on the CME information page.
Clifford R. Weiss, MD, FSIR
Professor of Radiology and Biomedical Engineering
The Johns Hopkins Hospital
Financial relationships: Full list of relationships is listed on the CME information page.
To study the safety profile, associated risk factors, and outcomes of complications following percutaneous sclerotherapy of peripheral venous malformations (VMs).
Materials and Methods:
Our vascular anomalies database was searched for patients with peripheral VMs who underwent image-guided percutaneous sclerotherapy between 2003 to 2022. Charts were retrospectively reviewed to extract patient demographics, VM location, presenting symptoms, treatment details, adverse events (AEs), and their outcomes. Univariate and multivariate logistic regression tests were used for prediction analysis.
Results:
202 patients (mean age: 26.2±15.8 years) with peripheral VMs were identified. Of them, 116 (57.4%) were adults and 87 (43.7%) were males (further demographic details are in Table 1). 621 percutaneous sclerotherapy procedures were performed under fluoroscopic, ultrasound, MRI, or CT guidance under general or moderate anesthesia with or without regional nerve block, with an average of 3.3±3.7 treatments per patient (range: 1-27). Sclerosing agents included ethanol (n=367, 59.1%), sotradecol (n=142, 22.9%), bleomycin (n=85, 13.7%), glue (n=11, 1.8%), onyx (n=11, 1.8%), and coils (n=4, 0.6%). 55 patients (27.2%) experienced post-sclerotherapy AEs with an overall rate of 8.8% (55/621) (Table 2). On analysis, patients with VMs in the extremities had a lower risk of AEs (OR=0.42, p=.03, 95%CI: -1.89, 0.17). Female patients had a higher risk of AEs (OR=2.29, p=.02, 95%Cl: 0.11, 0.59). Greater height increased the likelihood of AEs (OR=23.01, p=.02, 95%CI: 1.41, 6.16).
Conclusion:
In this study, the overall rate of AEs related to percutaneous sclerotherapy of peripheral VMs was lower than in previous studies {1,6}. VM in the extremities, female sex, and greater height are associated with AEs.